An Oath Grounded in the Constitution

Tomorrow, September 12, is the two-year anniversary of my swearing in as the Library’s fourth director since it officially became the US National Library of Medicine.

What a day that was!

I delivered my first major address to my NLM colleagues, with my family, friends, and NIH Director Francis Collins in the front row. I wanted NLM staff to know how much I wanted to know and work with them, and I wanted Dr. Collins to recognize what a great operation we already were.

I still treasure having my siblings and my mother here. My brothers, all five to 15 years younger than I, were impressed with the place but a little surprised that their sister was selected for this position and held in such high regard. (Ya’ gotta love brothers, right?)

The swearing-in itself took less than three minutes (including photos), but as I reflect on the occasion, they were the most important three minutes of the afternoon.

All federal employees take an oath of office, a requirement stemming from Article VI of the Constitution. The original oath, spare in its simplicity, stated, “I do solemnly swear (or affirm) that I will support the Constitution of the United States.” Over the years, the oath grew to include more conditions, with some additions—such as the Civil-War era’s Ironclad Test Oath—being short-lived. But the heart of the oath, upholding the Constitution, has never wavered.

The Constitution, a complex and much-debated document, establishes the three branches that provide our government’s structure and ensure a separation of powers, i.e., the legislative, executive, and judicial branches. Much of the Constitution details elements of government I have little to do with (at least directly), but the Preamble—only 52 words long—packs a punch.

These opening words set out the principles that guide us and unite us:

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

As I read and re-read these words, I realized these principles also establish the foundation of our work as federal employees. In fact, many of them underlie the very work we do here at NLM, and everything we accomplish ultimately points back to them.

The data and information we acquire, the products we develop, and the services we offer help patients, health professionals, researchers, and policy makers “promote the general welfare” of our citizens and “secure the blessings of liberty” through improved health and well-being.

We “establish justice” by ensuring fairness in our collections and in people’s access to them. Those collections must remain sufficiently broad and robust to provide an even-handed, impartial view of what health means in society. Our literature and data must be as balanced and objective as we can make them, limiting the intentional (or even unintentional) bias that privileges one perspective on health over another. Our terminologies, which literally label matters pertaining to medicine, health, and well-being, must expand beyond the biological definitions to include the social and behavioral domains. And our products and services must be equally accessible to all, which means that both our technology and our outreach efforts must make those products and services understandable and actionable to people of all levels of income, resources, and self-actualization.

And all of these actions, these authorities, these products and services we offer, come together—like the work of the federal government as a whole—to contribute to “a more perfect union,” one that ensures the benefits detailed in the Preamble “to ourselves and our posterity.”

Not surprisingly, I find that upholding the Constitution, as I swore to do two years ago, is woven so tightly into what I do that it’s inescapable. But reflecting on how I do it and what is means is powerful nonetheless. It brings perspective to the decisions we make, the investments we endorse, and the products and services we bring to society. And it reminds me, as I noted last year, why I do it—namely, for all of us, for “We the people.”

In the context of the work of the Library, what does it mean to you to support and defend the Constitution? I’d love to get your thoughts.